2. Increase your deductible

As that cushion grows, consider raising the deductible on your HDHP to lower your premiums. Start with a quote from your current insurer to avoid a medical exam, especially if your health has declined.

3. Purchase supplemental accident insurance

A low-cost supplemental accident policy can be a cost-effective way to lower your HSA-related costs.

Here's how it works: Let's say you're paying $700 a month, or $8,400 a year, in HDHP premiums with a $2,500 deductible, and you have $1,000 in your HSA. If you raise your HDHP deductible to $5,000, you can cut your monthly premiums to $500. However, you would be out-of-pocket for $4,000 in a medical emergency.

As an alternative, you could raise the deductible to $5,000 and buy a $4,000 supplemental accident policy for $35 a month (or $420 a year) to manage the shortfall. Combined with your $500 monthly HDHP premium (or $6,000 a year), you'd spend $6,420 annually -- a savings of $1,980 annually compared to the $8,400 you are currently paying with the lower deductible.

However, if you take this route, it's important to remember that the supplemental accident policy is intended strictly for accidents. It won't cover you in the event of illness.

4. Read the fine print

With increased competition has come increased policy complexity. So, be sure to read the fine print before changing policies.

Pay particular attention to the maximum lifetime payout (which typically runs in the $2 million to $5 million range), and check to see wither the insurance plan includes 100 percent prescription drug coverage, which literally can be a lifesaver today.

5. Set up an automatic policy review

Independent insurance brokers may offer a free annual policy review. If so, take them up on it; they can save you time and money with their knowledge of the current HSA marketplace.

As brokers, their commissions are paid by the insurance carriers, so their services are (or should be) free to you.

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